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Lipoprotein(a) apheresis in patients with peripheral arterial disease: rationale and clinical results

Norbert Weiss1, Ulrich Julius2

  • 1University Center for Vascular Medicine and Department of Medicine III-Section Angiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany. norbert.weiss@ukdd.de.

Clinical Research in Cardiology Supplements
|March 16, 2019
PubMed

Insights

Elevated lipoprotein(a) is a significant risk factor for peripheral arterial disease (PAD). Lipoprotein apheresis effectively lowers these levels, reducing cardiovascular events and improving limb outcomes in PAD patients.

Area of Science:

  • Cardiovascular Medicine
  • Lipidology
  • Vascular Surgery

Background:

  • Symptomatic peripheral arterial disease (PAD) patients face high cardiovascular risks.
  • Elevated lipoprotein(a) [Lp(a)] is a known risk factor for coronary artery disease (CAD) and stroke.
  • Emerging evidence links elevated Lp(a) to prevalent and incident PAD, potentially more strongly than to CAD.

Purpose of the Study:

  • To review the clinical significance of Lp(a) in PAD.
  • To summarize the effects of Lp(a) apheresis on PAD.
  • To suggest guidelines for screening and treating elevated Lp(a) in PAD patients.

Main Methods:

  • Literature review of studies on Lp(a), PAD, and lipoprotein apheresis.
  • Analysis of evidence linking Lp(a) to PAD prevalence, incidence, and outcomes.
  • Evaluation of the efficacy of Lp(a) apheresis in reducing cardiovascular and limb events.

Main Results:

  • Elevated Lp(a) is a potent risk factor for PAD.
  • Lipoprotein apheresis is the sole effective method for lowering Lp(a).
  • Lp(a) apheresis reduces major adverse limb events and improves PAD symptoms like exertional leg pain.

Conclusions:

  • Lp(a) plays a critical role in the pathophysiology of PAD.
  • Lipoprotein apheresis offers a therapeutic strategy for managing Lp(a)-associated PAD risk.
  • Screening for and treating elevated Lp(a) should be considered in PAD management.

Keywords:
AtherosclerosisCardiovascular preventionCritical limb ischemiaIntermittent claudicationPeripheral arterial disease

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